Provider Demographics
NPI:1508924192
Name:MAIER, JAMES T (PT, MS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:T
Last Name:MAIER
Suffix:
Gender:M
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 PHILOMETHIAN ST
Mailing Address - Street 2:P. O. BOX 636
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2926
Mailing Address - Country:US
Mailing Address - Phone:440-247-2476
Mailing Address - Fax:440-247-5278
Practice Address - Street 1:54 PHILOMETHIAN ST
Practice Address - Street 2:REAR
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-2926
Practice Address - Country:US
Practice Address - Phone:440-247-2476
Practice Address - Fax:440-247-5278
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT01368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0217705Medicaid
OH0217705Medicaid